
    <div class="container_12">
        <div class="grid_12 space1"></div>
        <div class="grid_12 img">
            <img src="public/img/09.png" alt="img"/>
        </div>
        <div class="grid_8 suffix_2 prefix_2">
        </div>
        <div class="grid_12 top2"></div>
        <div class="grid_2 prefix_2"><p class="text4">Numele:</p></div>
        <div class="grid_6 suffix_2">
            <input name="textfield" type="text" class="colortext"/>
        </div>
        <div class="clear"></div>
        <div class="grid_2 prefix_2">
            <p class="text4">{"Telefonul"|__}:</p>
        </div>
        <div class="grid_6 suffix_2">
            <input name="textfield" type="text" class="colortext"/></div>
        <div class="clear"></div>
        <div class="grid_10 prefix_2">
            <p class="text4">Mesajul:</p>
        </div>
        <div class="grid_8 prefix_2 suffix_2">
            <textarea name="textfield" type="text" class="colortext1"></textarea>
        </div>
        <div class="grid_12 space2"></div>
        <div class="grid_10">
            <form method="post" action="handler.php">
                <input type="image" class="buttonsubmit" src="public/img/btn_submit.png" alt="ОК"/>
            </form>
        </div>
    </div>
</div>